Listen to #Hashtag Hong Kong every Sunday morning at 8.15
Focussing on issues affecting civil society, we'll hear from representatives of NGOs, associations, statutory bodies, and non-profit groups.
(Sundays 8.15am - 8.25am)
We are pleased to share in Hashtag Hong Kong on an important topic of child protection. This year is our 45th Anniversary. Our mission is to promote a caring and non-violent environment for the optimal growth and development of our children through quality services in prevention, crisis intervention, treatment, training and advocacy.
On gravity of the problem, from year 2011 to 2019, there were around 800 to 900 cases of child abuse every year. This number has been increased by 45% last year to over 1,400 cases. Then you may ask why?
One of the reasons is increased public awareness, from high profile cases in 2018 and 2019. There was an increase in identification and reporting of abuse. In 2019, the Law Reform Commission issued a consultation paper ‘’Failure to Protect Offence.’’ This new offence tackles the question of ‘’which of you did it’’ in serious abuse or child deaths investigations. And a reference chapter on Mandatory Reporting of Child Abuse was included as additional information.
In 2020, professional awareness was heightened when the ‘’Procedural Guide for Multi-disciplinary Co-operation’’ was published by the Social Welfare Department, and delineation of roles and responsibilities of professionals was clearly made.
Then in 2020 the pandemic COVID-19 led to family conflicts, job insecurity, children at risk of sexual abuse online etc, adding to the toll of child abuse. Then in 2021, the community was shocked to know that 40 children were abused in a residential child home. So you can see how vulnerable children are in the society.
Even worse, it was estimated that only 1% of abuse cases come to the attention of professionals. Therefore, to save lives, early identification, reporting and intervention are vital. ACA has advocated Mandatory Reporting of Child Abuse for some 20 years. In 2013, the United Nations Committee on the Rights of the Child recommended Hong Kong to establish a mandatory reporting mechanism. In 2019, our Ombudsman suggested the same. Soon followed were Government consultations, debates, dialogues and forums among legislators, professional bodies and the community. Now the Mandatory Reporting of Child Abuse Ordinance was finally passed and will be in full effect in January 2026. A simple message – ‘’if you see a problem, you must step forward and ask for help.’’
The main causes of child abuse is a complex issue, multifactorial in origin. Poverty, domestic violence, lack of social support, financial difficulties, parents with mental health problems, drug taking, teenage pregnancies, parents abused as a child, unplanned pregnancy or early separation from parents are risk factors of child abuse. Online child sexual abuse and exploitation is another pressing concern. Such risks easily escalate if proper assistance is not rendered.
The word to remember about the long-term effects of child abuse is ACE - Adverse Childhood Experiences. In 1998, Dr Vincent Felitti and colleagues reported the relationships between the ACEs and leading causes of child deaths. There are seven ACEs: 1)psychological abuse, 2)physical abuse, or 3)sexual abuse; 4)violence against mother and household members who were 5)substance abusers, 6)mentally ill or suicidal, and 7)ever has been imprisoned. The more ACEs you have as a child, the more problems you have in adulthood, like diseases of the heart, lung and liver, cancer and bone fractures. People with 4 or more ACEs, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt in adulthood when compared to people with none.
In a study by the Centre of Disease Control and Prevention in the United States, the estimated average lifetime cost per victim of non-fatal child abuse, including childhood health care costs, adult medical costs, productivity losses, child welfare, criminal justice and special education costs was USD830,000 in 2015. The estimated average lifetime cost per abuse death was USD 16.6 million.
We advocate a number of issues. The institutional child abuse in 2021 was a serious wake up call. ACA has a strong view that each child-related organisation should establish its own ‘’organizational child protection policy’’. Our Child Protection Institute was established in 2013 works with organizations on this, such policy will greatly safeguard our children.
The Report by Law Reform Commission in 2021, ‘’Failure to Protect Offence’’ needs to be enacted soon to provide deterrence to those who knowingly fail to protect a child from serious harm or death. Further, the maximum penalty under section 27 of the Offences against the Person Ordinance should be reviewed. This has been recommended by the court in recent years.
There are many more to do in child protection. Our other advocacies include total banning of corporal punishment, child central databank to inform policies and practices, online safety for children, home visitation service for at-risk children which is well proven in its effectiveness in child abuse prevention, a comprehensive Child Ordinance and Child Policy.
To end with an important note, when we work with children, their best interest must take priority.
Lastly this morning, I would like to dedicate a song 小時候 by 路家敏 to remind us all our precious childhood moments.
Mental Health is a profoundly important global issue. Today, I want to shine a light on its critical impact in Hong Kong.
Recent local studies conducted by the Health Bureau from 2019 to 2023 have revealed that nearly 25% of over 6,000 youth have experienced various levels of mental distress and neurodiversity. The latest figures also showed a significant rise in suicidal rate among young individuals aged 10 to 29 since 2016. Alarmingly, the suicidal rate for female teenagers under 15-year-old reached an unprecedented level in 2023. Over aged 60 accounts for 40% of the overall suicide.
But I want you to know there is hope. Although we have faced the heartbreaking loss of some of our precious students since the start of this new academic year, it is important to remember that we can make a difference.
The risk factors contributing to this crisis are multifaceted and interrelated: the social isolation during the pandemic, global instability due to warfare and economic challenges. Natural disasters and global warming are also areas of deep concern for our youngsters, reinforcing their sense of hopelessness and helplessness.
However, international research over the decades had clearly shown that over 90% of those who died by suicide had underlying psychiatric disorders, two-thirds of which were related to anxiety and depression. Tragically, among the 30 students who passed away due to suicide in the first semester of 2023, only 30% had been receiving psychiatric services. This means that many were unfortunately not recognized by themselves, their families, friends or teachers and did not have the opportunity to receive appropriate and timely treatment.
But here’s the encouraging part: the vast majority of psychiatric disorders at any ages, if detected, if detected and intervened early, can lead to very good outcomes. Suicide is preventable.
Prevention strategies are vital and that’s where we all come in. Schools play a pivotal role in this effort. By raising awareness of the signs of stress among students and enhancing teachers’ and school social workers’ skills in risk detection, we can create a healthier school community and by extension a healthier wider community.
The government can also contribute by investing in preventive strategies within a Universal, Selective and Treatment framework, such as the 4Rs Mental Health Charter (Rest, Relaxation, Relationship, and Resilience) implemented by the Education Bureau as a universal prevention measure.
At the selective prevention level, further professional training using evidence-based approaches can be organized to empower schools as gatekeepers. By identifying students at risk, we enhance risk detection and enable early intervention.
At treatment level, we need to further enhance the accessibility of psychiatric services using a public-private partnership framework. Working collaboratively with community partners, including social welfare organizations and community psychiatrists, can make mental health services more accessible and available.
The Hong Kong Mental Wellness Association (HKMWA) has launched several programmes using treatment, selective and universal prevention framework to address the urgent mental health needs.
Firstly, at the treatment level, WeCare SOS Support Our Students programme was launched in December 2023 in collaboration with the Hong Kong Social Workers Association supported by various foundations, to address the escalating trend of students’ suicide. This initiative aims to facilitate early identification, appropriate and timely treatment of students showing signs of stress and suicidal risk. These students are cared for by community psychiatrists providing four sessions of free consultation and medication. Phase I has successfully run since December 2023 with over 200 students being identified and treated. Phase II supported by the Hong Kong Tuberculosis, Chest and Heart Diseases Association (HKTCHDA) will be launched in the fourth quarter of 2024, extending the age limit and increasing the number of free sessions, to address community needs identified in Phase I.
Secondly, at the selective prevention level, we provide professional training for school teaching and counselling staff, in collaboration with Hong Kong Heng Seng University and the Greater Bay Area Medical Professional Development Association, we will organize a free evidence-based training foundation course for teachers on October 29th 2024. The training aims to equip participants with essential skills for early risk detection and evidence-based intervention in handling students with mental health issues. Also, a scientific symposium on mental wellness will be held in collaboration with the Greater Bay Area Medical Professional Development Association and Hong Kong psychological professional bodies on October 18, 2024.
Thirdly, as for universal prevention level, we have been running a school wellness programme “De-stress Express (DSE)” since early 2023. This programme includes mental health talks and stress management workshops for high school students, teaching staff and students. The goal is to increase understanding of the importance of mental wellness and to equip participants with stress management skills for better physical and mental wellness. Up until now, over 36 schools have been covered with over 60,000 participants involved.
We will also collaborate with community partner, to conduct a free Mental Health First Aid course for students on November 2, 2024. The three-hour course aims to empower students to become mental wellness ambassadors who can detect their own signs of distress, and help their fellow classmates and friends, encouraging them to reach out to adults for help.
As we celebrate the World Mental Health Day on October 10, let’s remember that promoting mental well-being is a community effort. It involves parents, schools and mental health professionals, all working together.
Young people are our future. By raising awareness and equipping ourselves with self-help skills and the ability to help others, we can all face the challenges ahead and foster an inclusive, supportive environment for everyone in our community.
I’d like to dedicate a song by Carole King “You’ve got a friend”, because “it’s ok to be not okay”, and it is important to “always reach out when you’re troubled”. Just remember, “you’re not alone”. Let’s work together for a better mental health for all.